Exploring peer tutoring from the peer tutor's perspective

IntroductionChanging working practices, student numbers, workforce demands, and deficits, have created a need to consider new ways of radiography student training. One suggestion could be to implement Peer Assisted Learning (PAL) during clinical placements. PAL utilises social constructivist theories, where peer tutors teach lower or same level tutees, reinforcing and practicing material formally taught. The aim of this study was to trial an intervention of PAL, co-designed between the university and students and evaluated to identify opportunities and challenges.MethodsUsing participatory action research 8 final year student volunteers trialled a 3-week intervention, where they delivered PAL to first years, tutoring on first year radiographic clinical practice. Focus groups were held pre and post intervention to gather qualitative data.ResultsFocus group discussions were transcribed and collectively thematically analysed. Two students and the primary researcher took part in the analysis.ConclusionStudents identified benefits and challenges to PAL. Issue around preparing for and being a peer tutor are also discussed.Further study involving experiences of first year students and clinical colleagues is required.Implications for practicePeer-tutoring has potential benefits to students to facilitate the development of skills related to image analysis and critique as well as radiographic anatomy and patient positioning.     

Service user involvement in radiotherapy and oncology education; the patient perspective

IntroductionThe Health & Care Professions Council (HCPC) recently mandated the integration of the service-user voice into all aspects of allied healthcare education in the UK. However, the potential benefits and harms of this integration to service users are largely unknown. This study aimed to determine service user perspectives on relaying their personal experience of the cancer treatment pathway to students in an undergraduate Radiotherapy and Oncology programme.MethodsA qualitative study was conducted where seven patients led educational sessions with students and were interviewed (1:1) 1 week later using an iterative semi-structured format.ResultsUnanimously, the primary motivation for participation was the opportunity for patients to tell their unique story to positively influence the future behaviour and understanding of student healthcare professionals. Patients experiencing significant cancer-related psychological trauma reported reacting more emotionally to the experience but also reported particularly positive benefits from their participation, including therapeutic healing.ConclusionFindings highlight the array of benefits to service users associated with teaching in allied healthcare education. Post traumatic growth (PTG) may also potentially occur through this type of intervention in certain participants and this warrants further investigation in future studies.     

Peer review in MRI: A quality improvement programme and pilot study

IntroductionThe aim of this pilot study was to implement a peer review programme to evaluate MRI images and protocols, with the goal of improving quality and standardising protocols.MethodA plan-do-check-act method of action research was adopted. A checklist was designed and two radiographers scored the images (Optimal, Diagnostic or Suboptimal). A sample of five Lumbar Spine examinations were selected and reviewed on two separate occasions, one month apart. A consultant radiologist also scored the selected examinations.ResultsThere was excellent intra-rater reliability for both observers. At first assessment, Cohen's weighted Kappa analysis indicated moderate inter-rater agreement (0.457) rising to substantial agreement (0.606) at second assessment. Variations in sequence parameter settings by the radiographers were noted. Feedback via educational sessions were implemented and enhancement of protocols were made.ConclusionsRadiographers manipulate many parameters during MRI examinations, and image quality can be degraded if sequences are not optimised. This may lead to misinterpretation.Initial results suggest peer review can result in improved image quality, better protocols, and improved staff confidence.There are opportunity costs involved in releasing staff from clinical work and time and resources required for image appraisal training, however we suggest this model can be extended to other departments and modalities as a healthcare improvement initiative.Implications for practiceInitial results suggest peer review processes performed by radiographers can result in improvement to protocols and image quality in MRI. With appropriate training, radiographers can implement and undertake appraisal of image quality in MRI as part of clinical governance. The purpose of feedback must be made clear, and good professional relationships should be forged to allow candid and supportive feedback with a focus on development and education.     

Evaluation of different teaching methods in the radiographic diagnosis of proximal carious lesions

Objectives:To evaluate four different teaching methodologies in the radiographic diagnosis of proximal carious lesions and in the students’ perception of these methodologies.Methods:71 undergraduate dental students were subdivided into 4 groups according to the teaching methodologies used (traditional, hybrid, e-learning and problem-based learning). All methods were applied by two properly trained researchers. Initially, students completed a pre-methodology test (index test). After applying the teaching methodologies, the students were submitted to a post-methodology test containing periapical radiographs for evaluation of proximal carious lesions. Then, the students answered a questionnaire to verify their perception of the different teaching methodologies. Statistical analysis was done.Results:There were no relationship between the results of pre- and post-methodologies tests, irrespective of the teaching methodology employed (p > 0.05). No differences between the teaching methodologies studied (p > 0.05) were found regarding the amount of correct answers. However, the students who participated in the active (e-learning and problem-based learning) and hybrid teaching methodology reported a positive impact in relation to their diagnostic skills at the questionnaire.Conclusions:All the tested methodologies had a similar performance; however, the traditional methodology showed less acceptance by the students when analyzed subjectively and comparatively. The results of the present study increase comprehension about teaching methodologies for radiographic diagnosis of proximal carious lesions, and there is a potential to build on the knowledge base and provide practical support for students and educators.     

Reporting radiographer peer review systems: A cross-sectional survey of London NHS Trusts

IntroductionPeer review is frequently incorporated within radiographer reporting services. The aim of this study is to establish peer review systems used for radiograph reports provided by reporting radiographers in London.MethodsAn online cross-sectional survey of NHS diagnostic imaging departments was performed. Reporting radiographer demographics (number, frequency of reporting, scope of practice) and systems used to provide peer review of radiograph reports (review frequency, case selection, volume, outcome measure, practitioner performing the review) were collected.ResultsThirteen eligible responses were received (61.9% response rate). Variability was found between Trusts in the number of reporting radiographers, frequency of reporting sessions and scope of practice. Most Trusts (9 of 13, 69.2%) have active peer review systems for radiographer reporting. All peer review systems use random case selection, most often performed on a monthly basis. Both a fixed number or a percentage of cases reported were used, with true positive, true negative, false positive, false negative the most frequent outcome measure. Of the 12 Trusts that have or are planning a peer system, all currently or plan to use reporting radiographers to conduct the review, with five (41.2%) also using consultant radiologists.ConclusionPeer review of radiographer reporting is common in London NHS Trusts although there is variation in the methods used.Implications for practiceRadiographer reports frequently undergo peer review. Standardisation of reporting radiographer peer review systems should be considered, and a standardised systematic peer review system has been proposed.     

The Virtual Homeroom: Utility and Benefits of Small Group Online Learning in the COVID-19 Era

ObjectiveDuring COVID-19, Harvard Medical School pivoted to online learning. A large student cohort took a completely virtual Radiology clerkship with daily programming including virtual small group teaching sessions or “homerooms.”Materials and methodsOne hundred and eleven medical students were divided into 12 virtual small group sessions which emphasized foundational concepts. Uniform teaching materials were used across all homerooms in order to deepen understanding and allow insight into the working methods of radiologists. Students evaluated the homeroom learning and teachers for utility and benefit to their educational experience.ResultsMost students (93%) felt the homerooms provided an educational benefit and reinforced topics studied (77%). Most students (84%) felt the leaders created an environment conducive to learning. Despite being virtual, students were able to form interpersonal connections with the homeroom leaders.ConclusionsIncorporating virtual small group learning can be a valuable component of a virtual or hybrid Radiology clerkship, solidifying foundational concepts with the homeroom leaders playing a major role. While developed by necessity due to COVID-19, virtual small group learning with engaged leaders is an educational strategy whose benefit can continue even as there is return to in-person learning.     

Blending online techniques with traditional face to face teaching methods to deliver final year undergraduate radiology learning content

Aim

To review the initial experience of blending a variety of online educational techniques with traditional face to face or contact-based teaching methods to deliver final year undergraduate radiology content at a UK Medical School.

Materials and methods

The Brighton and Sussex Medical School opened in 2003 and offers a 5-year undergraduate programme, with the final 5 spent in several regional centres. Year 5 involves several core clinical specialities with onsite radiology teaching provided at regional centres in the form of small-group tutorials, imaging seminars and also a one-day course. An online educational module was introduced in 2007 to facilitate equitable delivery of the year 5 curriculum between the regional centres and to support students on placement. This module had a strong radiological emphasis, with a combination of imaging integrated into clinical cases to reflect everyday practice and also dedicated radiology cases. For the second cohort of year 5 students in 2008 two additional online media-rich initiatives were introduced, to complement the online module, comprising imaging tutorials and an online case discussion room.

Results

In the first year for the 2007/2008 cohort, 490 cases were written, edited and delivered via the Medical School managed learning environment as part of the online module. 253 cases contained a form of image media, of which 195 cases had a radiological component with a total of 325 radiology images. Important aspects of radiology practice (e.g. consent, patient safety, contrast toxicity, ionising radiation) were also covered. There were 274,000 student hits on cases the first year, with students completing a mean of 169 cases each. High levels of student satisfaction were recorded in relation to the online module and also additional online radiology teaching initiatives.

Conclusion

Online educational techniques can be effectively blended with other forms of teaching to allow successful undergraduate delivery of radiology. Efficient IT links and good image quality are essential ingredients for successful student/clinician engagement.     

Out of the Basement and Into the Classroom: Pathways for Expanding the Role of Radiation Oncologists in Medical Student Education

PurposeTo characterize radiation oncologist involvement in undergraduate medical education at US academic medical centers and to incorporate these findings into practical pathways for greater and broader integration of radiation oncology (RO) into medical curricula.MethodsChairpersons and residency program directors at RO departments directly affiliated with a medical school were asked to describe all the ways in which radiation oncologists in their department are involved in medical student education, excluding their elective clerkship.ResultsOf 75 eligible departments, 49 responded (response rate 65.3%). Twenty departments (40.8%) reported that at least one faculty member participates in a curricular educational session on an oncology-related topic. Twelve (24.5%) of these sessions were focused specifically on RO. Twenty-one departments (42.9%) had faculty involved with organized clinical shadowing or preceptorship programs for first- and second-year medical students. Twelve departments (24.5%) described no involvement in the formal curricula at their local or affiliated medical school. Thirteen departments (44.8%) described participation in a medical school–organized residency fair, and 12 departments (41.4%) sponsor an RO interest group. Reported novel approaches to teaching included development of multidisciplinary clerkships or educational sessions that include RO concepts, guest lectures on RO during a required clerkship, organized extracurricular experiences such as an oncology seminar series, participation in special medical student enrichment programs, and sponsorship or initiation of an RO interest group.ConclusionThe minority of RO departments are involved in formal teaching of the medical student body at large. The approaches described herein should facilitate more robust involvement of radiation oncologists in all areas of undergraduate medical education.     

First-Year Radiology Residents Teaching Anatomy to First-Year Medical Students: A Symbiotic Relationship

ObjectivesOur institution has developed an educational program in which first-year radiology residents teach first-year medical students during gross anatomy laboratory sessions. The purpose of this study is to assess the impact of this program on medical student knowledge and perceptions of radiology, and on resident attitudes toward teaching.Materials and MethodsFirst-year resident pairs taught small groups of medical students during weekly 15-minute interactive sessions, and were evaluated on teaching skills by senior residents. A survey about attitudes toward radiology and a knowledge quiz were sent to the medical students, and a survey about attitudes toward teaching was sent to the first-year radiology residents, both pre-course and post-course.ResultsStudents’ radiology knowledge significantly increased between the pre-course and post-course survey across all categories tested (P < 0.001). Additionally, there were significant improvements in terms of students’ confidence in radiologic anatomy skills, perceived importance of radiology for medical training, familiarity with the field of radiology, and perception that radiologists are friendly (P < 0.001). Radiology residents felt more confident in their teaching proficiency (P < 0.001) by the conclusion of the course.ConclusionsResident-led small-group teaching sessions during anatomy laboratory are mutually beneficial for medical students and radiology residents. The program also allows radiology residents to be exposed early on in residency to teaching and academic medicine.     

Adopting Review,Reflect and Re-focus [Triple R] sessions to support pre-registration therapeutic radiography students post clinical placement

IntroductionEducation and training strategies in Therapeutic Radiography are challenged in recruiting and retaining students in the profession. Clinical oncology centres are often viewed as stressful environments for students due to rapid advances in technology and reported bullying and harassment. Educators continue to work with clinical partners in developing strategies to promote resilience and reduce negative attitudes. The overall aim of this project was to explore the use of Triple R sessions as a new method of student reflection.MethodsThe Review, Reflect and Re-focus (Triple R) sessions were designed to enable students to learn from their clinical experiences and; apply their understanding and positivity when they return to clinical placement. Eleven sessions were completed across 7 student cohorts in one academic year. Qualitative data was collected from feedback forms, as well as academic field notes, and analysed thematically.ResultsTwo main themes focused on: (1) staff interactions and (2) student expectations. Results showed that Triple R sessions were helpful in drawing out the experiences of students in a positive way to reflect on their own development. The sessions enabled critical self-analysis and improved problem-solving skills, particularly evident during peer discussions.ConclusionTriple R sessions explored the influence of a positive approach on students' perceptions of their overall placement. Evaluation of the data indicated that, following academic and peer discussion, students' perceptions tended to be a more positive overall view of their placement.Implications for practiceTriple R sessions can be used in academic and clinical environments to enable positive student interactions.     

The use of near peer teachers in the radiography program at Monash University

IntroductionThis research investigated the perceptions of fourth year students as near peer (NP) teachers, and second year NP learners during a pathology unit in the Bachelor of Medical Imaging and Radiation Sciences at Monash University.MethodsA systematic review of literature was undertaken to inform the research design. Semi-structure pre- and post-teaching interviews were conducted with four NP teachers. An online survey was conducted with 50 second year NP learners. Quantitative data was analysed using Microsoft Excel. Interview data and 64 free text comments in the online survey were analysed using NVivo.ResultsNP students felt there were significant benefits being involved in the NP program, including an explanation of concepts and complementary teaching to lecturers. Three of the free text comments outlined a negative perception, although in each case the comment related to the student's individual learning style rather than being negative against the program.ConclusionThe benefits to learners in a pathology course was consistent to those identified within the literature. Students perceived benefits in terms of content delivery, interaction and communication. Recommendations were made about the organisation and design for future cohorts.     

Could musculo-skeletal radiograph interpretation by radiographers be a source of support to Australian medical interns: A quantitative evaluation

IntroductionPublic expectations regarding access to the emergency department (ED) challenges providers and policy makers with finite resources being stretched beyond capacity. To enable education of a greater numbers of doctors the format of the medical internship in Australia has changed and assumes that sufficient supervision is provided to interns to enable image interpretation skills development. Furthermore this assumes that appropriate foundational skills are established during undergraduate education.MethodsA mixed methods approach using a convenience, self selecting sample population of radiographers and final year medical students was adopted. The study measured the interpretive ability of final year medical students and radiographers in musculo-skeletal trauma (MSK) plain radiographic images. An image test bank based upon radiologist consensual agreement was corrected for prevalence and bias. Performance across a range of measurements was completed and compared for statistical significance using Mann–Whitney U.ResultsResults were divided to enable analysis across age ranges and types of skeletal presentation. Radiographer performance was better numerically and demonstrated statistically significant difference in several areas.ConclusionRadiographers have the knowledge base to assist junior doctors to clinically interpret the musculo-skeletal radiographic image. To meet the requirements of AMC and the Medical Board of Australia (MBA), a tailored clinically based educational system could be developed and provided by an accredited radiographer. Australian radiographers could also be employed to provide a safety net to avoid misinterpretation, such as seen in the UK commenting system, operating as an interprofessional team.     

E-learning in an undergraduate radiography programme: Example of an interactive website

PurposeTo demonstrate how e-learning can be integrated into an undergraduate radiography programme, using an academic subject dealing with ethico-legal issues as an example. Information provided could be applied to any form of online learning.MethodsOne academic subject from an undergraduate radiography programme, Case-Based Learning for Professional Studies, which had previously been taught using traditional face-to-face methods, was transformed into an e-learning format. Students who experienced the new e-learning format were evaluated by means of an online evaluation questionnaire.ResultsEighty-three percentage of respondents felt confident/semi-confident about participating in online Chat sessions. Around 34% of respondents thought that the Discussion Board was useful for communicating with fellow students. Nearly 70% of respondents believed that access to online materials enabled them to prepare for lectures and tutorials. However, 34% of students preferred more face-to-face lectures/tutorials. Overall, feedback was positive.ConclusionCourse providers and other relevant stakeholders need to be proactive in determining ways to facilitate undergraduate and post-registration development and learning. E-learning can be utilized to benefit learners who wish to work at their own pace and who cannot attend courses at remote sites. Individuals can reap the benefits of an online learning format and affording learners more flexibility and providing guidance for them, by means of a website, may help to promote a positive attitude to lifelong learning.     

The Integration of Active Learning Teaching Strategies Into a Radiology Rotation for Medical Students Improves Radiological Interpretation Skills and Attitudes Toward Radiology

PurposeIn recent years, there has been increased recognition of the benefits of teaching by active learning. However, there is a paucity of experimental studies utilizing active learning in undergraduate radiology rotations, which is traditionally a passive learning experience. We designed a new radiology rotation that integrated teaching by active learning. We prospectively examined the efficacy of this new rotation compared to our standard rotation in terms of students' radiological competency and attitudes toward radiology, as well as impact on departmental efficiency.MethodsThis was a prospective cohort study involving fourth year medical students completing a 1-week radiology rotation at our department between January and April 2018. One cohort completed a rotational model which incorporated active learning sessions (integrated cohort) while the remainder were taught using traditional passive learning methods (standard cohort). All participants completed a radiology examination before and after the rotation and were surveyed on their attitudes toward radiology.ResultsA total of 105 students enrolled in the study. The mean postrotation competency score obtained by the integrated cohort was significantly higher than that obtained by the standard cohort (82% vs 62%; P < 0.001). The integrated rotation freed up 7 hours of radiologists’ time per week. While the students completing the integrated rotation had a more positive perception of radiology, they were no more likely to express a desire to pursue a career in radiology.ConclusionsThe integration of active learning sessions into an undergraduate radiology rotation results in an improvement in students' postrotation radiological competency and attitudes toward radiology.     

Forensic undergraduate cohort; job readiness curricula

ABSTRACT

A self- and peer-assessment strategy was implemented to support learning, teaching and assessment of undergraduate forensic science students’ capacity to work in a team. This strategy aimed to fill the gap observed in teamwork assessment, which historically focuses on the project outcome rather than an individual’s performance within a team. The online assessment tool, SPARKPLUS, was chosen as the platform to provide students with the teamwork skills criteria and levels of achievement they were required to self and peer assess against, during forensic investigation assessment team tasks. This work-integrated learning involved three components: (1) processing a mock crime scene; (2) laboratory analysis of the evidence collected; and (3) development and presentation of a police brief of evidence. A comparison of the distribution of the self- and peer-assessment ratings from students in second- and third-year cohorts shows that this approach improves assessment of teamwork.     

The radiographer's perspective on X-ray examinations in potentially pregnant patients; results of a focus group study among Dutch radiographers

IntroductionThe Netherlands does not have a national guideline for performing radiographic examinations on pregnant patients. Radiographic examination is a generic term for all examinations performed using ionizing radiation, including but not limited to radiographs, fluoroscopy and computed tomography. A pilot study amongst radiographers (Medical Radiation Technologists (MRTs)) showed that standardized practice of radiographic examinations on pregnant women is not evident between Radiology departments and that there is a need for a national guideline as the varying practice methods may lead to confusion and uncertainty amongst both patients and MRTs.MethodsFocus groups consisting of MRTs from several Radiology departments within the Netherlands were used to map ideas and requirements as to what should be included in the national guideline. Nine focus group sessions were organized with a total of 52 participants. Using a previous review (Wit, Fleur; Vroonland, Colinda; Bijwaard H. Pre-natal X-ray exposure and the risk of developing paediatric cancer; a systematic review of risk factors and a comparison of international guidelines. Health Physics 2021; 121 (3):225–233), the following key points were chosen as discussion topics for the focus group sessions: dose reduction, confirming pregnancy and risk communication.ResultsResults showed that the participating MRTs did not agree on the use of lead aprons. That the national guideline should include standardized methods to adjust parameters to decrease radiation dose. Focus group participants find it difficult to ask a patient's pregnancy status, especially when dealing with relatively young and old (er) patients. When communicating the level of risk associated with a radiographic examination the participating MRTs would like to be able to use examples and comparisons, preferably by means of a multilingual website.ConclusionA national guideline must include information on justification, available alternatives, dose reductions methods and confirmation of pregnancy requirements when fetal dose is a significant risk.Implications for practiceA national guideline ensures standardized practice can be implemented in Radiology departments, increasing clarity of the issues for both patients and MRTs.